Provider Demographics
NPI:1003058348
Name:TSAY, ANNA TERESA MENDOZA (ANP-BC)
Entity Type:Individual
Prefix:
First Name:ANNA TERESA
Middle Name:MENDOZA
Last Name:TSAY
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:ANNA TERESA
Other - Middle Name:PALAGANAS
Other - Last Name:MENDOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-BC
Mailing Address - Street 1:393 E WALNUT ST
Mailing Address - Street 2:PHR GROUP PROVIDER ENROLLMENT UNIT FL 3
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91188-0001
Mailing Address - Country:US
Mailing Address - Phone:877-608-0044
Mailing Address - Fax:877-514-0903
Practice Address - Street 1:3913 YORK BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90065-3718
Practice Address - Country:US
Practice Address - Phone:323-532-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18500363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health